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Subjective Experience and Satisfaction of Augmented Reality-Based Exercise Program Developed to Improve Exercise Adherence for Patients with Mood Disorders

Kyungwon KIM ; Eunsoo MOON ; Hwagyu SUH ; Hyun Ji LEE ; Byung Dae LEE ; Young Min LEE ; Hyunju LIM ; Du-Ri KIM ; Jong-Hwan PARK ; Myung-Jun SHIN

Mood and Emotion.2024;22(2):45-52. doi:10.35986/me.2024.22.2.45

Background: Although exercising can be effective in alleviating mood symptoms, implementing an exercise regimen can be challenging. This study aims to evaluate the subjective experience and satisfaction with an exercise program that uses augmented reality (AR) developed to improve exercise adherence in patients with mood disorders. Methods: Thirty patients diagnosed with mood disorders participated in this study. Before and after the AR-based exercise program, psychological states were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). In addition, the satisfaction survey conducted after participating in the exercise program was analyzed. Results: The mean score of PHQ-9 decreased significantly following the exercise program. Moreover, the mean scores for GAD-7 and PSS significantly decreased when compared before and after the exercise program. Meanwhile, the mean score of WHOQOL-BREF for physical and social satisfaction increased significantly. Furthermore, this program received positive responses on the satisfaction survey. Conclusion In patients with mood disorders, the AR-based exercise program showed remarkable positive effects on psychological states and satisfaction levels. The exercise program using AR technology may effectively improve exercise program adherence in patients with mood disorders.

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Differences Between Positive and Negative Perceptions of Stress Based on Patterns of Coping Strategies: Through Mobile Application in College Students

Hwagyu SUH ; Eunsoo MOON ; Suhyun PARK ; Byung-Dae LEE ; Young-Min LEE ; Kyungwon KIM ; Hyunji LEE

Mood and Emotion.2024;22(2):37-44. doi:10.35986/me.2024.22.2.37

Background: Stress management is an important component of management of mental health. Stress processing can be understood as the appraisal of and coping with stress. This study aimed to compare positive and negative perceptions of stress according to patterns of coping strategies. Methods: The study recruited 116 college students who completed the Perceived Stress Scale and Coping Inventory for Stressful Situations using a tablet PC or smartphone application. K-means cluster analysis was used to categorize the subjects into three clusters. Results: Positive perceptions were highest in Cluster 2 (i.e., task and avoidance dominant) at 3.18±0.66 followed by 2.30±0.65 in Cluster 1 (passive coping) and lowest in Cluster 3 (emotion dominant) at 1.75±0.63. Negative perceptions were highest in Cluster 3 at 2.45±0.66 followed by Cluster 1 at 1.66±0.65 and Cluster 2 at 1.07±0.68. Conclusion Differences in coping patterns can reduce the negative effects of stress. Thus, assessing the perception and management of stress can be useful and help people change their coping styles to more adaptive ones. Toward this end, a mobile application can be an appropriate tool.

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Effect of Metabolic Syndrome and Metabolic Abnormalities on Remission of Bipolar Disorder Inpatients: A Retrospective Chart Review Study

Suwan KIM ; Young Sup WOO ; Won-Seok CHOI ; Won-Myong BAHK

Mood and Emotion.2024;22(1):27-35. doi:10.35986/me.2024.22.1.27

Background: Associations between metabolic abnormalities and poor treatment outcomes in bipolar disorder (BD) have been reported. This study examined the influence of metabolic abnormalities on remission in Korean inpatients with BD. Methods: This study retrospectively reviewed the chart of 128 adult patients with BD who were hospitalized at a university hospital in Korea. The collected data included fasting plasma glucose, total cholesterol, triglycerides, and high-density lipoprotein levels at admission, as well as height, weight, and blood pressure measurements. The prevalence of metabolic abnormalities was compared between the remission (17-item Hamilton Depression Rating Scalescore of ≤7 and Young Mania Rating Scale score of <8) and nonremission groups. Results: Prevalence of hyperglycemia and hypertriglyceridemia significantly differed between the nonremission and remission groups. Multivariate analysis revealed hyperglycemia as the only significant risk factor for nonremission in subjects with mood and manic/hypomanic episodes. Conclusion The study findings reveal a negative effect of hyperglycemia on the treatment outcome of BD. Clinical attention to metabolic abnormalities, specifically insulin resistance and hyperglycemia, is recommended during early stages of the disease.

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Comparison of the Safety and Weight Loss Efficacy of Metformin and Liraglutide in Psychiatric Outpatients at a University Hospital: A Retrospective Chart Review

Mansuk SEO ; Won-Seok CHOI ; Young Sup WOO ; Won-Myong BAHK

Mood and Emotion.2024;22(1):1-9. doi:10.35986/me.2024.22.1.1

Background: Metformin (MET) has been used to prevent weight gain in patients treated with antipsychotic drugs. However, liraglutide (LIRA), initially used for diabetes, is now considered for obesity treatment. The aim of this study was to investigate the effectiveness and safety of these drugs in patients with psychiatric disorders. Methods: A retrospective chart review was performed on patients prescribed and administered MET and LIRA from January 1, 2017 to August 31, 2023. To assess treatment efficacy, the mean change in the body mass index of the patients before and after drug use was calculated for both medications. Drug safety was evaluated by determining the early discontinuation and occurrence of adverse effects. Results: We collected data from 45 patients, with the majority being women (84.4%). The most frequently diagnosed psychiatric disorders were depressive disorder for LIRA (35.3%) and psychotic disorder for MET (63.6%). No demographic variations were observed between patients who were administered the two types of drugs. The treatment efficacy and safety of both drugs did not show any statistically significant difference. When conducting a subgroup analysis exclusively on patients diagnosed with psychotic disorders (n = 14), MET showed better efficacy; however, no statistically significant difference was observed (−2.48±3.17 vs. 0.56±2.93, t=−1.860, p=0.088). Conclusion LIRA and MET did not show any significant differences in terms of therapeutic efficacy and safety. However, in patients diagnosed with psychotic disorders, MET showed better efficacy and was cost-effective than LIRA. Future studies with larger sample sizes are required to confirm these findings.

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Efficacy of Naltrexone-Bupropion and PhentermineTopiramate in Psychiatric Patients:A Retrospective Study at a University Outpatient Clinic

Min-Kyu SONG ; Won-Seok CHOI ; Young Sup WOO ; Won-Myong BAHK

Mood and Emotion.2024;22(1):19-26. doi:10.35986/me.2024.22.1.19

Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

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Circadian Rhythms, Depressive and Anxiety Symptoms, and Chronotype: Interaction and Implication for Mental Health in Healthy Subjects

Jung Won YOU ; Yoonyoung NAM ; Rina YU ; Vin RYU

Mood and Emotion.2024;22(1):10-18. doi:10.35986/me.2024.22.1.10

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

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Differentiating Adjustment Disorder from Post-Traumatic Stress Disorder: Symptom Survey of Psychiatric Outpatients in South Korea

Taejin PARK ; Daeho KIM

Mood and Emotion.2024;22(3):103-110. doi:10.35986/me.2024.22.3.103

Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

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Prevalence of Depressive Symptoms and Related Factors Among Elderly Individuals Living Alone in Jeju

Hyun-Ju YANG ; Young-Eun JUNG ; Moon-Doo KIM

Mood and Emotion.2024;22(3):94-102. doi:10.35986/me.2024.22.3.94

Background: Depression among elderly individuals, especially those living alone, is an important social issue. This study investigated the prevalence of depressive symptoms and related factors in elderly individuals living alone in Jeju. Methods: A survey was conducted among elderly individuals living alone and registered in the Basic Senior Care Services. Depressive symptoms were analyzed using the Short Form Geriatric Depression Scale, with scores ≥6 indicat-ing depression. Factors such as sex, age, education level, marital status, income, health status, underlying diseases, smoking, alcohol consumption, and suicide risk were also examined. Results: Of the 4,742 participants, 52.6% showed a high prevalence of depressive symptoms. Factors affecting prevalence included sex (p=0.020), age (p<0.001), education (p<0.001), subjective health (p<0.001), smoking history (p<0.001), cancer (p=0.001), dementia (p<0.001), and diagnostic history of depression (p<0.001), whose symptoms were correlated with suicidal thoughts, plans, or attempts (p<0.001). Multivariate logistic regression indicated that sex, age, education level, subjective health, dementia, and current smoking and alcohol consumption were significant factors. Conclusion Depression among elderly individuals living alone in Jeju is severe and influenced by sociocultural factors. Early detection and mental health policies are essential to reduce its prevalence and socioeconomic impact.

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Recognizing and Understanding the Association Between Depression and Physical Illnesses

Saeheon JANG

Mood and Emotion.2024;22(3):53-62. doi:10.35986/me.2024.22.3.53

Depression, which has a prevalence of 2%-5% among the general population, has shown higher rates (6%-14%) among those with chronic medical conditions, particularly neurological (epilepsy: 20%-55%; multiple sclerosis: 40%-60%; and stroke: 14%-19%), vascular (up to 80% in stroke), endocrine (diabetes and hypothyroidism), and painrelated disorders like fibromyalgia. Recognizing this link is crucial for holistic healthcare, highlighting the importance of addressing mental health alongside chronic illness management. Diagnosing depression in these patients requires a comprehensive approach, potentially involving psychological assessment tools. Treatment focuses on identifying and addressing organic causes, minimizing resistance to psychiatric treatment, and selecting appropriate pharmacotherapy while considering potential interactions and side effects.

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Effects of Hospital-Based Case Management on Relapse Prevention and Functioning in Patients with Severe Mental Illness

Sang-Geun PONG ; Kyungmin KIM ; Bo-Hyun YOON ; Young-Hwa SEA ; Suhee PARK ; Jye-Heon SONG ; Ha-Ran JUNG ; Yuran JEONG ; Hyunju YUN ; Jaegil JO ; Hangoeunbi KANG

Mood and Emotion.2024;22(3):87-93. doi:10.35986/me.2024.22.3.87

Background: This study aimed to determine the effectiveness of hospital-based case management for patients with severe mental illness. Methods: A total of 106 patients were included. To evaluate the effectiveness of hospital-based case management, the number of hospitalizations, cumulative length of hospitalization, and hospital days/year as well as functioning were compared before and after the hospital-based case management intervention. Cox regression was performed to identify variables that may influence readmission rates other than patients’ hospital-based case management interventions. Results: The number of hospitalizations decreased from 1.4±0.9 to 0.5±1.0 (p<0.001), cumulative length of hospitalization from 73.0±62.3 to 28.1±57.2 days (p<0.001), and hospital days/year from 20.0±17.1 to 7.7±15.7 days (p<0.001). The changes in Global Assessment of Functioning (GAF) Scale were 35.3±15.7 points at case management intervention, 43.7±13.9 points after 1 month of case management (p<0.001), 51.2±14.1 points after 3 months (p<0.001), and 53.1±17.6 points after 6 months (p<0.001). Demographic and clinical characteristics that influenced readmissions were GAF at admission (p=0.017), duration (p=0.042), diagnosis (p=0.019), and type of admission (p=0.001). Conclusion Hospital-based case management significantly improved readmission rates and functioning in patients with severe mental illness, supporting its continued implementation and expansion.

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